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Current Perspectives on Idiopathic Intracranial Hypertension without Papilloedema
Article

Magnetic Resonance Imaging Features and Clinical Findings in Pediatric Idiopathic Intracranial Hypertension: A Case–Control Study

1
Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
2
Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, MA 02115, USA
3
Department of Radiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
4
Department of Radiology, Phoenix Children’s Hospital, Phoenix, AZ 85016, USA
5
Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Steffen Hamann, Susan Mollan, Heather E. Moss and Nicola Smania
Life 2021, 11(6), 487; https://doi.org/10.3390/life11060487
Received: 24 February 2021 / Revised: 15 May 2021 / Accepted: 25 May 2021 / Published: 27 May 2021
(This article belongs to the Special Issue Idiopathic Intracranial Hypertension)
The purpose of this study is to identify salient magnetic resonance imaging (MRI) findings of pediatric IIH, to determine the relevance of these findings with regard to disease pathogenesis, and to relate these findings to the clinical presentation towards identification of risk factors of disease. A retrospective, a case–control study of 38 pediatric patients with and 24 pediatric patients without IIH from the ophthalmology department at a tertiary care center was performed. Clinical data, including ophthalmic findings and lumbar puncture results, were recorded. Neuroimaging, including both MRI and magnetic resonance venography (MRV), was evaluated for perioptic subarachnoid space diameter enlargement, posterior globe flattening, optic nerve head protrusion, empty or partially empty sella turcica, dural venous sinus abnormalities, skull base crowding, and prominent arachnoid granulations. Compared with controls, IIH patients had larger perioptic subarachnoid space diameters, higher incidences of posterior globe flattening, protrusion of the optic nerve heads, an empty sella turcica, and dural venous sinus abnormalities. A perioptic subarachnoid space diameter of ≥5.2 mm was identified as an independent predictor of IIH (p < 0.001) with sensitivity of 87% and specificity of 67%. Several significant MRI findings in pediatric IIH were identified. Using a model that uniquely incorporated clinical and MRI findings at presentation, we provide a framework for risk stratification for the diagnosis of pediatric IIH which may be utilized to facilitate diagnosis. Future prospective work is needed to further validate the model developed in this study. View Full-Text
Keywords: pediatric idiopathic intracranial hypertension; pediatric pseudotumor cerebri; papilledema pediatric idiopathic intracranial hypertension; pediatric pseudotumor cerebri; papilledema
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MDPI and ACS Style

Gilbert, A.L.; Vaughn, J.; Whitecross, S.; Robson, C.D.; Zurakowski, D.; Heidary, G. Magnetic Resonance Imaging Features and Clinical Findings in Pediatric Idiopathic Intracranial Hypertension: A Case–Control Study. Life 2021, 11, 487. https://doi.org/10.3390/life11060487

AMA Style

Gilbert AL, Vaughn J, Whitecross S, Robson CD, Zurakowski D, Heidary G. Magnetic Resonance Imaging Features and Clinical Findings in Pediatric Idiopathic Intracranial Hypertension: A Case–Control Study. Life. 2021; 11(6):487. https://doi.org/10.3390/life11060487

Chicago/Turabian Style

Gilbert, Aubrey L., Jennifer Vaughn, Sarah Whitecross, Caroline D. Robson, David Zurakowski, and Gena Heidary. 2021. "Magnetic Resonance Imaging Features and Clinical Findings in Pediatric Idiopathic Intracranial Hypertension: A Case–Control Study" Life 11, no. 6: 487. https://doi.org/10.3390/life11060487

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